The Reanimation of Alison

Alison Delgado won the first marathon she ever entered—Cincinnati's Flying Pig—then was nearly killed in a traffic accident. Miraculously, she returned to the starting line of that event, thinking of winning once again.

It's late afternoon, early last October, and runners and their families and friends have gathered in Cincinnati's Ault Park for the popular 5-K known as the Reggae Run. The brisk air carries the scent of grilled meat and the metallic twang of steel drums. Vendors set up tents, adding to the party-like atmosphere of the race in which runners often sport fake dreadlocks tucked into red, yellow, and green Rasta tams and call out a spirited "Ya, mon!" to cheering spectators.

Near the starting line, where a dozen or so top runners stretch and jog in place, Alison Delgado scans the crowd of spectators. She's a slight, 28-year-old local runner with auburn hair and a smattering of freckles. Spotting her husband, she waves him over.

"Tim, I gotta run fast," she tells him, her hazel-colored eyes darting back and forth.

A year ago, Tim might have just nodded in agreement, but these days encouraging his wife's competitive nature is not his priority. "Ali," he tells her. "Remember, relax, have fun." Then they exchange a quick kiss, and Tim steps back into the crowd.

Moments later, the starting gun fires, sending nearly 4,000 runners off through the undulating park. Tim, slim but athletic, quickly turns away from the bubbling scene and hurries toward the park's summit, which offers a panoramic view of the city. He wants to be in position near the finish line before Alison arrives.

On paper Alison should be a contender in the women's race. Two months earlier, in another 5-K, she PR'ed with a time of 18:39. Even more impressive is that at the 2005 Cincinnati Flying Pig Marathon, when she was just 22 and a recent college graduate about to enter medical school, she won her debut marathon. She crushed a field of 1,467 women in 3:03:52, three minutes, 40 seconds faster than the second-place finisher. "When I crossed the finish line," Alison would say later, "I thought, Oh my God. I did it. I really did it. Without a doubt it was one of the best days of my life."

And yet, while memories of that victorious run remain fresh, they can't obscure all that's happened in Alison and Tim's lives over the past year, events Alison is reminded of each time she looks into a mirror—or hears, as she does now, the anxious tone in her husband's voice. When Tim finally spies a tiny bobbing blob of pink and black beginning an ascent up the quarter-mile hill, he calls out, a bit more relieved than excited, "It's Ali! It's Ali! She's in first!"

Seconds later, when she passes him, cheeks pink, doe-like eyes focused straight ahead, Tim yells, "Let's go Ali! C'mon, babe, you can do this, only 150 yards to go. Keep it up! Keep it up!" As 19:35 flashes on the clock, and with the nearest female competitor nearly a minute behind, Alison Delgado crosses the finish line, staggering into the chutes, chest rising and falling rhythmically. When she emerges, Tim hurries over, grinning. "You won—nice job, babe!" and wraps her in his arms. A small cluster presses around the two offering congratulations, and soon a race organizer signals it's time to photograph the winners. Alison, though, lingers for a moment with Tim. She shrugs her narrow shoulders against the chilly wind. Tim slips an arm around her, and she leans into his embrace, momentarily buffered from the cold.

ON OCTOBER 16, 2010, a much balmier autumn afternoon a year earlier, Tim Delgado, M.D., was deep into his shift at University Hospital when a call came in on the radio: "AirCare 1 and Pod Doc, request for a flight from Mercy Anderson coming back to University Hospital."

"Pod Doc copies," Tim responded, then hustled to the elevator that would take him to the hospital's rooftop. He was on call that afternoon to ride on the hospital's medical helicopter, ferrying patients from other hospitals back to University—the only facility in the region with the equipment and doctors to treat serious trauma victims. As a second-year resident in emergency medicine, Tim had been chosen for the flight program because of his ability to remain calm under pressure, critical during a helicopter ride when patients are often clinging to life.

Soon he was soaring over the city, full of adrenaline, thoughts racing with emergency medical protocols. Minutes later, the helicopter landed in the parking lot of Mercy Anderson, a small hospital 12 miles from downtown Cincinnati. Tim rushed inside where a doctor briefed him on the patient, a female cyclist who'd been hit by a car and suffered a severe head injury.

The woman's blood pressure was high and her heartbeat slow—several times it had dipped to just 30 beats per minute—and there were indications of brain swelling. She was in a coma and had scored a 5 on the Glasgow Coma Scale, a test that measures a patient's responsiveness to various stimuli. A normal GCS score is 15; a 3 often means the person is in a vegetative state.

Tim glanced at the woman. Her head was cushioned between two blocks with a cervical collar around her neck to hold it steady. A breathing tube was inserted in her mouth. He noticed her blue cycling jersey, then saw the "Team Hungry" logo on her shorts. That's my cycling team, he thought. There were only two women on the team. One of them was Ali, his bride of five months. His heart began to pound. Her face was bloodied, her jaw twisted. Please don't let it be Ali, he thought as he glanced back up.

GIVEN THE unseasonable warmth of that day, Alison Delgado, who had just worked 13 days straight as a pediatric resident at Cincinnati Children's Hospital, couldn't wait to get outside and work out. Instead of running, though, she decided to ride her bike. Cycling was really Tim's sport. He'd coaxed Alison into it after they first started dating four years earlier and had even proposed to her after they both completed a grueling ride up a Colorado mountain. Alison preferred running, but she'd developed a passion for cyclocross, an event that reminded her of cross-country. Because she had a race coming up, she decided to go for a long ride, 30 miles, heading southeast from her congested urban neighborhood toward the leafy suburb of Anderson Township.

She was cruising down a long hill, hugging the right curb of Corbly Street, a major thoroughfare, when a driver coming the opposite way began a left turn onto Berkshire Club Drive. Alison entered the intersection just as the driver swung into the turn. First came the squeal of brakes, then the sickening thud of a body, Alison's, slamming into the car frame, before catapulting over the roof and landing with a horrifying thump on her back. In an instant she had broken several vertebrae in her neck, jaw, clavicle, sternum, bruised her heart and lungs and, worst of all, torn an artery in her brain. Unconscious on the pavement, she gurgled and choked as blood pooled in her airways. Drivers rushed from their cars. Someone called 911.

IN THE CHAOS OF Mercy's emergency ward, Tim finally stammered out, "That's my wife," and the room full of doctors and nurses grew silent.

"What?" someone asked.

"That's my wife," Tim repeated. He put his hands on the back of his head, took a deep breath and walked out of the room. In the hallway, he leaned against a wall and sank to the floor.

Realizing that Tim could no longer treat Alison, a nurse got on the phone to request another ER doctor. As they waited, Tim, sick with worry, called University to give them all the information he could so they'd be even more prepared to treat Alison. Then he insisted on riding back in the helicopter with her. "I'm not leaving her," he told the other doctors and nurses.

At University, Alison lay unconscious in the neurological intensive care unit, her dark hair tangled with leaves and twigs from the accident site. A thin feeding tube was taped to her nose, a wider one, delivering oxygen, was attached to a hole in her trachea. A heart-rate monitor beeped rhythmically.

Early on, Dr. Brian Stettler, an ER doctor at University, told Tim that Ali's prospects for survival "did not look good." A brain scan revealed the torn artery in Alison's brain had caused an aneurysm to form and burst. Pressure from swollen brain tissue had temporarily stopped the bleeding, but the doctors worried that too much inflammation could squeeze the arteries shut, causing a massive stroke. They knew that even if Alison survived the first 48 hours, considered the most crucial after a traumatic brain injury, much could still go wrong, especially during the first week: fevers, seizures, new bleeding. "It's basically a roller-coaster ride," says Dr. Lori Shutter, a neurointensivist who treated Alison. "There will be a good day followed by a bad day... sometimes it's not even day to day, sometimes it's hour by hour."

Tim, meanwhile, was determined to use his medical knowledge to help Alison survive. He rarely left her side. If her eyelids fluttered, a sign she was having a seizure, he would flag down one of the neurologists. If she coughed, he'd grab a nurse and ask her to clean out Alison's trachea tube.

He comforted himself by thinking of Alison's fitness and mental drive. She had been her high school valedictorian, had graduated magna cum laude from Eastern Michigan University in three years, and been accepted to her medical school of choice, the University of Cincinnati. Yet nowhere was her resolve more apparent than in her desire to be a competitive runner.

At Colerain High School, Alison—the elder child of an engineer and stay-at-home mom who grew up on Cincinnati's blue collar west side—made the varsity cross-country team freshman year. Not an easy feat, says her old coach, Ron Russo. "We probably had eight or nine [future] Division I runners on that team," says Russo, who has won four Ohio state cross-country titles. The first time he understood Alison's drive, he says, was in her sophomore year, in 1998. Alison had a bad race, and Russo demoted her to junior varsity right before the regional meet. The girl who replaced Alison helped the team qualify for states, forcing Russo to choose that runner or go back to Alison for the championship meet. Before making the decision, Russo got an unexpected visitor to his office. "Little 15-year-old Alison walks in," Russo says. "She looks at me with those big eyes and says, 'Russ, run me. I promise I won't let you down.'" It was the conviction in her voice, Russo says, that convinced the coach to put her in the lineup. Alison had her best race of the year as Colerain won the state title.
The two won a total of four state championships before Alison left to run at Eastern Michigan. While success in college failed to match that of her high school career, Alison never lost her love for running, even while pushing through an academic load filled with premed courses. In the fall of 2005, after graduating college and while applying for med school, she took a job assisting Russo. She also began training for her hometown's Flying Pig Marathon, some weeks putting in 85 to 90 miles of roadwork.

On race morning Alison purposely took the first mile slow, at an eight-minute-per-mile pace. Soon, though, her training began to pay off. At mile six, she moved into second place, and by mile 13 she was leading the pack. Running behind the pace car, Alison was now the object of cheering crowds. She squelched the temptation to speed up, reminding herself she had another half-marathon to go. "I had to keep telling myself to stay calm," she told a local newspaper reporter after the race. "I couldn't let everybody cheering and screaming make me go too fast." By mile 25, Alison knew she had the race wrapped up when a marathon cyclist told her the second-place runner was six minutes behind.

Still, she never let up. "Notice how beautiful her stride is still," said Julie Isphording, a former Olympic marathoner doing TV commentary for the race. "To be able to run this pace in the last mile and look this good... is really an amazing feat." Alison crossed the finish line with her arms raised in victory, a smile on her face.

AFTER ALISON'S FIRST FEW DAYS at University, brain scans showed the swelling was starting to recede and no new bleeding had occurred. The doctors could also get her to wake up for a few seconds at a time, by shaking her bed or clapping their hands. But it wasn't until the fifth day that Alison voluntarily opened her eyes. She could not speak because her jaw was wired shut, and she did not focus on anyone or anything. Often she was delirious, babbling, trying to pull out the tubes attached to her body. "At this point, we thought she had a good chance of surviving and being functional," says Dr. Andrew Ringer, a neurosurgeon at the Mayfield Clinic at University. "But that's a far cry from surviving and being a doctor. We had considerable concerns that she might not regain her language skills and memory adequately to perform her job."

Slowly, though, Alison began to shown signs of her old self. Days after she first opened her eyes, her dad, Terry Bedingfield, escorted an old high school cross-country friend into the room, and Alison, who had yet to show that she understood the severity of her condition, burst into tears. Trying to diffuse the moment, Terry borrowed the Tom Hanks line from Alison's favorite movie, A League of Their Own. "Crying?" Terry said. "There's no crying in recovery!"

Just like that the tears stopped, and Alison's eyes narrowed. The look, so familiar from Alison's teenage years, thrilled Terry. "When I saw that," he said, "I knew she was going to be okay."

But a week later a brain scan revealed the aneurysm was growing, rapidly. The neurologists decided to perform a procedure called "coiling" in which copper wire is injected through an artery in the leg up to the brain and plugs up the aneurysm so it's less likely to burst. After the procedure, doctors finally removed the wiring from her jaw. "I love you," she croaked to Tim. She had been at University for 17 days and was no longer in critical condition. The doctors decided it was time for her to go to a rehabilitation hospital to work on her memory, speech, strength, and coordination. With her broken vertebrae, clavicle, and sternum still healing, she wore a neck brace whenever she was out of bed. Her lower body, though, was fine, and she was soon up and walking and then running, albeit very slowly, on a treadmill. One month after the accident, she went home.

At the time, Tim says, "I thought, 'We're done. It's over. We're gonna get on with our lives.'"

But on the third day after returning home, Alison had severe head pain and started to vomit shortly after the couple went to bed. Tim dialed 911, and soon an ambulance was rushing her back to University. Despite the coiling, the aneurysm had burst again. The neurologists would now have to try a riskier surgery, digging into the brain tissue to find the affected part of the artery and attaching a metal clip at the base of the aneurysm, to close it off. They also needed to build a bypass to reroute blood supply away from that part of the artery. The neurologists were not confident the clipping would be successful, in which case they would have to build a bigger bypass, which would mean cutting off blood flow to several smaller arterial branches. If that happened, Alison could possibly lose her vision and suffer some paralysis. Massive stroke was also a possibility, as was death if the surgeon could not control the bleeding once he cut open the artery.

The night before the surgery, Alison's usual stoicism dissolved and she clung, sobbing, to her parents. "I was terrified at that point," she says. "I was thinking, I worked my butt off my whole life to get where I am right now, to be a doctor, and that might all be taken away, and I might end up being a burden to Tim."

The next day, after nine hours of surgery, Tim walked into post-op and saw a sight only a spouse who is also a doctor might grasp as reassuring: Alison in bed, crying and clutching the left side of her head with her hand. "I knew just looking at her the surgery had gone well," he says. "She was alert, receiving pain messages, and reacting appropriately."

ON A SUNNY AFTERNOON in late February, Alison walks into one of her favorite burger joints, Arthur's, in Cincinnati's Hyde Park neighborhood with Tim and her parents. The chrome and dark-wood eatery is packed with young families and couples perched on bar stools, drinking microbrews, and watching a basketball game. Earlier in the day, Alison logged 16 miles at a seven-minutes-per-mile pace, and her cheeks are still rosy with the afterglow of hard exercise. She's in a teasing mood, telling her parents, Terry and Kathy, that Tim gave her a GPS watch as a Valentine's Day gift to track her runs.

More than a year has gone by since the accident, and Alison looks virtually unaffected by it. She has a small scar on her neck from her tracheotomy, but the other scar, the one that runs along the entire left side of her face, is hidden beneath her hair. Because the aneurysm was on the left side of her brain, which controls the right side of her body, her right grip is slightly weaker than her left, but that problem does not extend to her right leg. "Her gait hasn't changed at all," Tim says. "She's always been a smooth runner. And she still is." While Alison's scars are mostly physical, she knows that is not the same for Tim and her parents. She reaches over, puts a hand on Tim's knee, and says, "I think my getting back on a bike [which she did last spring for the first time], especially, was harder for Tim than it was for me."

"I don't know why you still want to ride," he says, glancing over at her.

"You got me into riding. And I don't remember anything about getting hit."

"I remember for you."

"I know," Alison says. "I know." Then, she adds, "Rather than the memory of the accident, I've had to deal with the results of it. It was hard to deal with them, but I did. Now I feel like I just have to move on. I've never seen or talked to the person that hit me, and I don't need to. I mean, I hope she knows that I forgive her. I think about it every time I see a bicyclist. I think, Wear your helmet and be careful because people aren't paying attention. I think to myself that I could have done the same thing. I could have hit somebody, and it scares me." She pauses. "I just know it was a crazy, tragic accident. God was with me that day and through my recovery... and it wasn't my day. It wasn't my day to die."

Alison went home just two days after the clipping surgery (although the neurologists scheduled a second clipping surgery for a month later to remove a dormant aneurysm). They also gave her the green light to perform more intensive physical therapy—though nothing as jarring as running until after the final surgery. At first she didn't have much stamina. She had lost nearly 20 pounds and was so weak when she went to the gym that she needed to hold Tim's hand to perform a simple lunge or calf raise. Slowly, though, her strength increased. By the end of January, she had worked her way up to 30 minutes on the elliptical machine and no longer fell asleep before dinner.

In late March 2011, doctors permitted her to start running. Her first time, Alison went with Tim on a three-mile loop around their neighborhood. It had been six months since she'd run. She forced herself to run more slowly than she wanted to and not to run the next day. "The whole time I was thinking, I'm so grateful I'm able to do this," she says. "Everything could have turned out so differently." Soon she was running every day. To appease Tim, she ran on the sidewalks and wore a bright yellow jacket, headlamp, and blinking red light clipped to her chest in the early morning or evenings. "One time I ran by this guy and he said, 'Nobody's gonna miss you!'" she says with a laugh. "And I was like, Yep! That's the point!'" She and Tim had been asked to be the official starters for the 2011 Flying Pig, so Alison suggested they run the 5-K together the day before. Her old competitiveness was coming back, and she told Tim she wanted to finish in less than 21 minutes. She did, coming in third, with a time of 20:31, while holding Tim's hand.

A month later, Alison won a small local 5-K, and a few months after that, she PR'ed at another with a time of 18:39—a feat she attributes not to any special training but to a flat course and a relaxed attitude: "I wanted to win, but I wasn't putting pressure on myself to win." In the meantime, she was easing back into her medical residency, starting with easy rounds in dermatology and other outpatient rotations rather than the ER, which might require her to work overnight or through the weekend. In October, she did the Reggae Run, followed by a 10-K at Thanksgiving. All the while, she was mulling over registering for the 2012 Flying Pig Marathon. In January she finally committed to the race, which takes place May 6.

To some, like Terry, her dad, it seems crazy to attempt something so ambitious barely a year after her final brain surgery, especially since, unlike the last marathon attempt, she is now an overworked medical resident. But Alison doesn't feel the need to wait. "I know that everything can change in a moment," she says. "That kind of knowledge makes me want to do this now when I'm running really well. It's a chance to show that I'm back. That I've really beaten this thing."

Tim says he is not worried. "It's the safest strenuous form of exercise she could do," he says. "And I'd rather she be running than riding a bike." They both also like the idea that Alison's running a marathon will send a positive message to others who suffer traumatic brain injuries. "I want to give people hope," she says. "It's my way of saying, 'Never give up because if you work hard, you can achieve amazing things.'"

Like her preparation for her victorious 2005 marathon, Alison is training hard. She went from 25 miles a week in December to 70 by March. She also does between ten and twelve 400-and 800-meter repeats once a week. In a 15-K tuneup race in March, she finished in 59:56, good enough for fifth place (before winning the Flying Pig Marathon in 2005, Alison finished seventh in the same race). Her marathon preparation occurs around her busy residency, which some months requires her to get to the hospital by 6 a.m. and work through the night.

Terry tells his daughter that just finishing the marathon is enough; that she doesn't have to win it again. And Alison agrees. After all that has happened she knows just finishing would be a victory. But she can't help but want more. When asked about it, she looks away, embarrassed for a moment, then says firmly, "Yeah, I do. I want to win."

EXACTLY ONE YEAR after the accident, on October 16, 2011, Tim, Alison, and their extended families gather near the intersection where the accident occurred. It's a warm day with not a cloud in the sky, eerily reminiscent of the prior year. The group stands on a patch of grass that separates the bustle of Corbly from the first house on Berkshire, a quiet residential lane. At 10 minutes past five, the time of the impact, the sun has started to slide westward, behind the trees on the north side of Corbly, causing the upper half to be shaded while the lower half is still bathed in late afternoon light. Anyone driving up toward the intersection would be looking directly into the sun. Anyone coming down, especially a cyclist, would be in shadows.

Alison asks the group to gather in a circle. The breeze tosses her chestnut hair around as she talks about how grateful she's been for the support of family and friends and how she believes she survived because "God had plans for me." As she speaks, the rumble of passing cars occasionally drowns out her words. Soon other family members speak, a prayer is recited, tears wiped away. Throughout it all, Tim remains silent. A few months earlier, he'd forced himself to ride his bike by this same spot, to feel the same bumps in the road that Alison had on that day, to cross the same intersection. The memory of almost losing her is still raw, and he often cannot talk about it without a lump forming in his throat. So he keeps his eye downcast, gripping Alison's hand. She squeezes back.

Update: May 6, 2012

Alison Delgado set a PR in today's Flying Pig Marathon, running 2 minutes and 18 seconds seconds faster than she did when she won the marathon in 2005. The 29-year-old who is profiled in this month's issue of Runner's World crossed the finish line with a time of 3:01:34. She came in fourth overall among the women.

"After the article came out a few days ago, I was getting messages on Facebook and emails from people I don't even know ... people cheering me on," she said. "I felt like I had so many people supporting me today. It was awesome."

Delgado nearly died after she suffered a severe head injury after being hit by a car in October 2010. She endured several brain surgeries and spent months recovering before she resumed running again in late March 2011. Both she and her husband, Tim, are doctors and he spent nearly every waking moment by her side, helping her to recover.

On Sunday Tim rode his bike along the marathon course and stayed by his wife's side during the last seven miles, telling her: "You've been through much worse than this, you can do it." After crossing the finish line, the couple embraced and Alison burst into tears. "I told her, 'I love you. I'm so proud of you. You ran awesome,'" Tim Delgado said.

Alison said she might have gone out a little too fast. Her pace early in the race was 6:40 per mile and she led the race from mile 11 to mile 19. But after mile 19, she began to tire and when the eventual winner, Rachel Bea, passed her at mile 20, she says, she knew Bea was probably going to win. "She's a very strong runner," Alison said.

Alison 's pace slowed to about 7:40 per mile for the last few miles, yet even at that pace, she was less than 30 seconds behind the second and third place winners. She said she was more than satisfied with her results.

"I'm just amazed and blessed that I'm here and healthy and I was able to go out and run the race," she said. "My message today was, 'Don't give up. Don't ever give up because you can achieve amazing things if you just keep trying'."

Alison plans to take a few weeks off from running. Her next goal? The 2013 Boston Marathon. "I'll be finished with my medical residency then," she said. I'll have more time to train so it seems like a good time to do it."